Raising the Bar for the Field of CBT

Opening remarks from Dr. Judith Beck at the Beck Institute Excellence Summit
October 20, 2018

Good Morning. While you’re all settling in, I’d like to tell you a story about a client I saw recently.

I’ll call her Mary.

Mary was in her early seventies and had spent almost every waking hour sitting alone in a lounge chair in her living room for a very long time.  She was severely depressed and, in fact, said she had been depressed for her whole life. Mary said the chair made her feel safe—and the thought of getting herself out of the chair made her feel unsafe.  She made lots of predictions about how terrible the day would be if she had to leave the house. Her chair was her refuge and that’s where she wanted to be.

Mary had been highly suicidal. She’d given up all hope that her life could ever get better and she said she probably would have killed herself years ago if it weren’t for her family. And maybe for that chair.

So I asked Mary what her mood was like when she first sat down in her chair of refuge each morning. She said she felt relief. Then I asked what her mood was like an hour later—did she still feel relief and protection? Quite the opposite. Mary said that after sitting in the chair for only an hour, she felt more depressed. And after sitting in it all day, she felt utterly hopeless and was bombarded by thoughts of suicide.

Here’s how I conceptualized Mary’s problem. She predicted that sitting in the chair would make her feel better than doing anything else. But she was wrong. Sitting in the chair hour after hour after hour actually made her feel much worse, and greatly increased the risk of suicide. So I said to Mary, “Mary, this chair doesn’t sound like a place of refuge to me. It sounds like a suicide chair.” With that, she sat up straight. Her face looked shocked. She said, “I think you’re right. I never thought about it like that!”

Mary started therapy and because she was able to see the chair in a different light, she was amenable to making plans to get out of the chair and back into life. Once she did that, her depression lifted and she was able to enjoy life in a way that she hadn’t for many years.

Why am I telling you this story? To make the point that conceptualization—and especially how you view a situation—is a critical element in problem-solving. Recognizing that our nonprofit mission is to improve lives worldwide through excellence in CBT, how do we conceptualize what is happening in the field of CBT?  We’re working to understand the challenges and to create solutions to improve CBT at a local and a global level.

Why?

Because like all of you, we want to provide the most effective treatment for our clients. We believe if we raise the bar for the field, all of us here in this room, and CBT therapists around the world, will be able to deliver more effective, time- and resource-efficient treatment–and reduce the suffering of countless more individuals.

Our journey in conceptualizing the problem begins with what we all recognize as a significant practice gap between what therapists do and what research tells us they should do. Some may not have been well-educated in CBT from the start. Others may suffer from therapist drift, conceptualizing clients eclectically. And there are some who haven’t kept up with the research and so practice the kind of CBT that was taught 20 years ago.

We have plans to solve this problem. And we hope we have your support in seeing them through.

In June of this year, the Beck Institute Board of Directors gave us a mandate to create the Beck certification program for individuals, which we will initiate in January, along with Beck accreditation for organizations.

In the past 24 months alone, the Beck Institute has educated over 14,000 trainees in 112 countries.  And as we celebrate our 25th anniversary, we believe we are delivering on our non-profit mission to promote excellence in CBT to help people recover from their conditions, function more effectively, and enjoy higher quality lives. You believe that as well, which is why you’re here today. And there are others, not here this morning, who also believe in what we’re doing. Literally hundreds of therapists tell us every year that they want Beck certification.  Our multi-leveled certification will measure and reward competence. We intend to set rigorous standards for certification and re-certification, effectively raising the bar on the practice of CBT among clinicians everywhere.

We’re raising the bar by increasing our online training to as many people, in as many countries as we can and we have already begun to make CBT skills training available to paraprofessionals as well.

We’re raising the bar by creating online communities of individuals who are working toward certification and those who have become certified.

We’re raising the bar by expanding our training offerings to broader audiences such as the military, community health systems and other entities that serve a more non-traditional CBT clientele.

And we’re raising the bar by establishing an accreditation program for CBT clinical and training organizations worldwide that are staffed by certified clinicians and educators.

The decision to offer certification was not made lightly. Our Board of Directors felt it was a vital part of our mission. And for me, it also speaks to my father and his legacy. It is deeply personal for me. We’re doing it because we believe the bar needs to be raised and that multitudes more individuals should become certified.

We think it’s the right thing to do. And we need your support in doing it.

The Beck Institute is and always has been the standard bearer for CBT. This certification and accreditation effort will strengthen our ability to connect and partner with other CBT-minded individuals and organizations worldwide to ensure the bar is raised for everyone.

Certification and accreditation are only one way we will be influencing the field into the future. We plan to help CBT researchers obtain much more funding. We plan to lead the dissemination of CBT in the postgraduate world as well as training non-professionals worldwide. And, we plan to help practitioners adopt the latest advances in evidence-based technological interventions to make CBT more universally available, more effective and less expensive.

Beck Institute has always been a non-profit organization, supported by a small but loyal group of philanthropists. To help ensure that we can successfully execute all of this positive growth and change, we have begun a broader fundraising effort. And, just this summer, we launched the Aaron T. Beck Fund in honor of my dad, our founder, to support everything we do each year. Some information on the Beck Fund is in your packets today, but please reach out to anyone on our team if you have questions about our fundraising effort, or how you might participate. We hope we can count on your support.

We also count on your input. You are on the front lines every day and know better than most the issues that face us. We would like to ask you to participate in working groups, to help drive the conversation about how to raise standards and increase quality.

We also invite your criticism about the job we are doing.  No organization, including ours, has all the answers, but together we can forge new pathways and collectively, we can raise the bar.

We hope you will join us on that journey beginning today. I would love to leave today’s summit with a set of goals that we can announce to the rest of the community that shows how serious we are about identifying key issues and solutions.

In closing, let me welcome all of you to Philadelphia on behalf of the staff, the Board of Directors, and my father. We’re thrilled to have you here for our second Summit and we look forward to the conversations we’ll have together today. I hope to speak with as many of you as I can, here at the Summit and on an ongoing basis.

Thank you for coming and helping us fulfill our non-profit mission of improving lives worldwide through excellence in CBT.

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